Question regarding metastasis

I was diagnosed with a 2.5cm invasive papillary carcinoma with metaplastic component, grade 3 and estrogen only positive and negative lymph nodes. I had a mastectomy followed by 4 treatments of TAC and will shortly be starting zoladex for min 2 years. How worried should I be regarding distant metastasis via blood vessals. I was feeling pretty good about my prognosis until I heard you could develop metastatis through this means. I am scheduled for a bone scan and CT scan of thorax and abdomen in May. Thank you in advance

[CCF-RN,MSN-rf]

Dear moneu:  It is believed that metastasis can occur both through the lymphatic system and through the bloodstream.  The probability of metastasis increases based on the stage of the disease and some other prognositic factors.  You would likely benefit from a discussion with your oncologist who can give you the statistics regarding the possibility of recurrence.  Keep in mind that chemotherapy and hormone therapy are designed to reduce the risk of recurrence.  You may also wish to discuss with your oncologist the value of tamoxifen for your situation.

[moneu]

Sorry I meant 6 treatments of TAC

[moneu]

I forgot to tell you I am 35 years old with no family history. Sorry again

[rayonc]

Metastasis can occur when the tumor was originally present.  They can occur throught the blood or lymphatic channels.  You need to remind yourself that all of the cancer we could find was removed.  All of the treatment you are receiving is preventative.  We know from previous experience that some women with tumors with the same pathologic features will develop disease at other sites.  We are not smart enough to figure out who will or won't but know enough to predict who is at higher risk.  That is why women are offered chemotherapy and hormone therapy. Given your young age may also wish to discuss genetic testing with your oncologist